Provider Demographics
NPI:1467806828
Name:ZIESEMER MALUSI, JANET
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:ZIESEMER MALUSI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:
Other - Last Name:MALUSI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RD
Mailing Address - Street 1:3751 W MILLER RD
Mailing Address - Street 2:
Mailing Address - City:SHEPHERD
Mailing Address - State:MI
Mailing Address - Zip Code:48883-9653
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3751 W MILLER RD
Practice Address - Street 2:
Practice Address - City:SHEPHERD
Practice Address - State:MI
Practice Address - Zip Code:48883-9653
Practice Address - Country:US
Practice Address - Phone:989-488-7096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-21
Last Update Date:2016-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered